Articles Posted in Failure to Diagnose

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A recent study published in Pediatric Reseach documents the relationship between abnormal PCO2 and unfavorable outcomes in infants suffering from hypoxic ischemic encephalopathy.  The object of the study was to determine if hypocapnia could be correlated with adverse outcomes in infants with moderately severe to severe hypoxic ischemic encephalopathy.

The study utilized 234 instances of hypocapnia to determine if there was independent predictive value in data concerning abnormal PCO2 levels and abnormal outcomes for these children.  The studies authors determined that there is independent predictive value in the relationship between hypocapnia and adverse and unfavorable outcomes.

The authors of the study determined that future studies of normocapnia will be important in determining the extent of the relationship between abnormal PCO2 and adverse outcomes in infants with moderately severe to severe hypoxic ischemic encephalopathy.

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The Illinois Appellate Court, First District has decided that when a plaintiff dies during medical malpractice litigation, even after the statute of limitations has run, the estate can add a wrongful death claim.  Previously, plaintiffs were faced with inconsistent statutes which made this scenario unclear.  In Lawler v The University of Chicago Medical Center Justice Delort, writing for the appellate court, resolved this conflict in favor of justice for the victims of medical malpractice.

The court found that since the defendants were on notice of the claim for medical negligence brought by Ms. Prusak before her untimely death that same complaint was not barred by the expiration of the statute of limitations or repose simply because her death claim did not accrue until after the expiration of the same because the original claim was filed within the statute.

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In 2003 the American College of Obstetricians and Gynecologists(ACOG), along with the American Academy of Pediatrics, published Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology (“NEACP”). This monograph became more commonly known as “the Green Book” and it has been roundly criticized as an attempt by its authors to use “junk science” to create hard an fast “essential” criteria to diffuse obstetrical malpractice claims against Ob/Gyns. In the more than 10 years since its publications its authors have backed off the allegedly essential nature of its core criteria and physicians have been forced to admit that factors like cord blood ph levels above 7.0 can still occur in births where the fetus experiences perinatal asphyxia that is the result of negligence.

Recently, ACOG published an update to the Green Book titled Neonatal Encephalopathy and Neurologic Outcome, Second Edition. This update changes some of the so-called “essential” criteria that expert witnesses have relied upon to defend causation in birth injury cases.

The update defines Neonatal Encephalopathy as a clinically defined syndrome of disturbed neurologic function in the earliest days of life in an infant born at or beyond 35 weeks of gestation, accompanied by early onset seizures and difficulty initiating and maintaining respiration and depression of fetal tone and reflexes. The update relaxes the criteria which obstetricians and pediatricians feel demonstrate the likelihood of peripartum or intrapartum ischemia playing a role in the pathogenesis of neonatal encephalopathy.

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Abbott Laboratories best selling drug, Humira, has been linked to a host of serious side effects, including severe neurological injuries. Abbott’s is on track to sell $15 billion worth of the drug per year by 2015. Abbott already expects to sell close to $10 billion worth of Humira in 2012. Humira is used to treat a variety of rheumatological conditions, including, Rheumatoid Arthritis and Ankylosing Spondylitis as well as Crohn’s disease.

In 2009, Abbott included the following warning in the package insert for Humira under section 5.5 titled, Neurologic Reactions:

“Use of TNF blocking agents, including HUMIRA, has been associated with rare cases of new onset or exacerbation of clinical symptoms and/or radiographic evidence of demyelinating disease. Prescribers should exercise caution in considering the use of HUMIRA in patients with preexisting or recent-onset central nervous system demyelinating disorders.”

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The following blog entry comes courtesy of a guest blogger, Stacy H. Federico, who has a blog devoted to raising awareness of Type II Diabetes and the benefits of healthy eating. We would like to thank her for her contribution to our blog.

Taking 10,000 steps every day (or walking about five miles) is incredibly useful to you.

I started walking 30 days ago. I wake up every day at 5:30 and walk about 5 mls (with my dog).

I had been so happy with myself. Recently a buddy told me, “What are you currently doing for exercise today?” I informed her about the walking, and she said, “Yeah, but what exactly are you doing for exercise?”

She declared that walking does not get the heart rate up sufficiently and won’t do one thing to enhance my overall health or my waist line and that if I needed to lose any weight, I needed a true workout.

Well , I informed her the 10,000 steps philosophy isn’t new…the good news is the 10,000 steps regimen has additionally been linked with an increase in insulin sensitivity in over 50 adults.

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A low vitality score, better known as an Apgar score, at birth is a strong predictor of a later diagnosis of Cerebral Palsy according to a new study published on bmj.com. The authors learned that children with an Apgar score of less than 3 at birth had a 100 times more likely chance of developing cerebral palsy than those with an Apgar score of 10. The correlation between a low Apgar and cerebral palsy was highest in children with normal birth weight and modest in children with low birth weight.

The study measured these correlations in more then a half million Norwegian children born between 1986 and 1995. Of those children almost 2 in 1000 were given the diagnosis of Cerebral Palsy before they reached the age of 5.

The most important conclusion to be drawn from this data is that Cerebral Palsy is closely related to factors that also effect infant vitality, something that has been strongly suspected in medicine for years. Low Apgar scores can be indicitive of a brain injury that has occured at the time of birth.

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The Deficit Reduction Act of 2005 (DRA) overhauled Medicare’s perspective on payment for medical care related to “never events” including a list of delineated hospital acquired conditions. Hospitals will no longer receive reimbursement for conditions that are (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been prevented through the application of evidence-based guidelines. The ten categories for hospital acquired conditions are: Foreign Object Retained After Surgery,.Air Embolism,,Blood Incompatibility, Stage III and IV Pressure Ulcers, Falls and Trauma including, Fractures, Dislocations, Intracranial Injuries, Crushing Injuries, Burns and Electric Shock, Manifestations of Poor Glycemic Control including, Diabetic Ketoacidosis, Nonketotic Hyperosmolar Coma, Hypoglycemic Coma, Secondary Diabetes with Ketoacidosis and Secondary Diabetes with Hyperosmolarity, Catheter-Associated Urinary Tract Infection, Vascular Catheter-Associated Infection, Surgical Site Infection Following Coronary Artery Bypass Graft (CABG) – Mediastinitis, Bariatric Surgery, Laparoscopic Gastric Bypass, Gastroenterostomy, Laparoscopic Gastric Restrictive Surgery, Orthopedic Procedures and Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE).

While the Centers for Medicare and Medicaid Services (CMS) have prohibited hospitals from recovering payment for the treatment of secondary conditions acquired in the hospital, practically, these charges are often submitted and paid by Medicare long before and attorney becomes involved and makes a claim for medical malpractice. Careful examination of the supporting documentation Medicare provides at the time they require reimbursement often reveals that benefits were paid for hospital acquired events.

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Goldberg & Goldberg is pleased to announce that they have settled a wrongful death case involving the death of a newborn child for $1,625,000.00. The case, Vega v. St. James Hospital, et al, involved the negligent diagnosis and management of fetal distress of mother and child during labor and delivery at St. James Hospital in Chicago Heights, Illinois in 2002. The baby survived a little over one hour before he ultimately died due to complications surrounding his resuccitation.

The defendants claimed that the child suffered from a microscopic pathologic defect which prevented him from being able to adequately perfuse oxygen in utero. The child is survived by his parents and three brothers and sisters.

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Goldberg & Goldberg partner, Ian R. Alexander, secured a $1,000,000.00 settlement in the case of Newburg v. Swedish American Hospital, et al 02 L 263 which is pending in Winnebago County, Rockford, Illinois. In 2001, the day before Thanksgiving, Margaret Hoffman went to Swedish American Hospital complaining of chest and back pain. Doctors in the Emergency Room were able to determine that she was not having a heart attack. Her cardiologist ordered the hospital to perform a CT Scan of Ms. Hoffman’s chest in order to rule out an aortic aneurysm as the cause of her pain. The hospital did not carry out the order for a CT scan until 48 hours later when Ms. Hoffman experienced a drop in her hemoglobin which indicated that the aneurysm had ruptured. Unfortuntely this intervention came to late and Ms. Hoffman, a 61 year old clerk at Zion Development Corporation, passed away on the operating table.

Ms. Hofman was survived by her two adult children. Records indicate that this settlement was one of the largest recoveries in recent history in Winnebago County for a wrongful death case where the survivors were adult children, and one of the few cases to settle in Rockford for in excess of $1,000,000.

We are very proud of the hard work that we did for Ms. Hoffman’s family. From the beginning all of the defendants claimed that Ms. Hoffman’s death was a result of her own poor health and had nothing to do with the numerous mistakes that they made in caring for her while she was a patient at the hospital over the Thanksgiving holiday in 2001.

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Lawyers at Goldberg & Goldberg secured a $5 million dollar settlement on behalf of a 22 year old man who was brain injured at birth when his labor and delivery at Northwestern Memorial Hospital was negligently managed by resident physicians. The labor and delivery was managed by residents because the plaintiff was a low income patient and in 1988 Northwestern Memorial Hospital had a policy of allowing residents manage the delivery of patients who did not have private physicians.

The plaintiff was able to file his lawsuit against Northwestern thanks to a law in Illinois that preserves the rights of brain injured people against the statutes of limitations and repose which would have ordinarily run. Goldberg & Goldberg challenged the statute of limitations law in a prior lawsuit and helped create this protection for brain injured children in a prior piece of litigation.

The settlement money in this case will be used to buy our brain injured client a handicap accesible home, electric wheelchair and a special van with a lift, among other things. He and his mother have had to do without this assistance for the past 22 years.